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FINANCIAL IDENTIFICATION PRIVACY STATEMENT  http://ec.europa.eu/budget/library/execution/privacy_statement_en.pdf ACCOUNT NAME (3) ACCOUNT NAME (1) ADDRESS TOWN/CITY POSTCODE COUNTRY (1) The name or tittle under whic h the accoun t has been opened and not th e name of the authorized agent  CONTACT TELEPHONE FAX E - MAIL BANK BANK NAME BRANCH ADDRESS TOWN/CITY POSTCODE COUNTRY ACCOUNT NUMBER IBAN (2) (2) If the IBAN Code (International Bank acc out numb er) is applied in th e country where your bank is situated  REMARKS : BANK STAMP + SIGNATURE OF BANK REPRESENTATIVE DATE + SIGNATURE OF ACCOUNT HOLDER : (Both obligatory)(3) (Obligatory) (3) It is p referable to attach a co py o f recent bank statement. Please note that th e bank statement has to pro vide all the information listed above under 'ACCOUNT NAME' and 'BANK '. In this case, the stamp of th e bank and the sig nature of the bank's representative are not  required. The signature of the account-holder is obligatory in all cases.

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FINANCIAL IDENTIFICATION

PRIVACY STATEMENT   http://ec.europa.eu/budget/library/execution/privacy_statement_en.pdf 

ACCOUNT NAME (3)

ACCOUNT NAME (1)

ADDRESS

TOWN/CITY POSTCODE

COUNTRY

(1) The name or t it t le under whic h the accoun t has been opened and not th e name of the

author ized agent 

CONTACT

TELEPHONE FAX

E - MAIL

BANK

BANK NAME

BRANCH ADDRESS

TOWN/CITY POSTCODE

COUNTRY

ACCOUNT NUMBER

IBAN (2)

(2) If the IBAN Code (International Bank acc out n umb er) is applied in th e country where

your bank is si tuated 

REMARKS :

BANK STAMP + SIGNATURE OF BANK REPRESENTATIVE DATE + SIGNATURE OF ACCOUNT HOLDER :

(Both obligatory)(3) (Obligatory)

(3) It is p referable to attach a co py o f recent bank statement. Please note that th e bankstatement has to pro vide all the information lis ted above under 'ACCOUNT NAME' and 'BANK '.

In this case, the stamp of th e bank and the sig nature of the bank's representat ive are not 

required. The signature of the account-holder is obligatory in all cases.